NURSING STUDENTS' PERCEPTIONS OF ENGLISH AS A LINGUA FRANCA

Provoked by the Faculty of Nursing’s graduate career prospective, ‘nurse in international nursing services’, this study aimed to investigate the Englishes nursing students were in favour of and the Englishes they needed for their future career and to find out their perceptions toward English as a Lingua Franca (ELF). Taking the form of a case study, this study collected data through open-ended questionnaires and semi-structured interviews. The findings generally highlighted paradoxes in participants’ views of ELF. Students were found to be in favour of Standard English (SE), although in the future what they truly expected from patients was the intelligibility to create therapeutic conversation. Furthermore, the participants seemed to be aware of the variety of Englishes in existence but believed that SE should be taught in class. This study also found out that local accents speak for their cultural identity. Therefore, the implication of the study calls for attention to the potential benefits of introducing ELF and provides some recommendation of how ELF could be best introduced at classrooms.


INTRODUCTION
One of the graduate profiles of the faculty of nursing of Universitas Pelita Harapan is 'a competent professional care provider' in which the career prospective is becoming 'nurse in international nursing service' in which English is inevitably embedded.
Looking in depth, the international context is no longer about crossing border.The implementation of the international collaboration frameworks like that of the ASEAN Free Trade Area (AFTA) as well as the World Free Trade Area has opened access to the world interconnectedness.Thus, even living in Indonesia, the nurses will eventually meet the international patients at hospitals.To further highlight, the international patients here do not particularly refer to those who are the native speakers but mostly with those who are not (Gallaway and Rose, 2015).They will have different backgrounds, cultures and languages in which English will be used as the medium of communication.
In ASEAN, English is used as the only working language for meetings and publications (Kirkpatrick and Sussex, 2012) and becomes the only unity language (Mauranen, 2016).So, whenever countries meet, English is used to discuss about the target and what to be implemented in ASEAN.This reality poses the challenge of how to prepare the nursing students ready for the pervasive international communities.To answer this challenge, Jenkins (2006;2009;2011;2016;2018) initiated the new use of English known as 'English as Lingua Franca (ELF)'.ELF is the use of English in which the speakers do not share the same first language and are not the speakers of English.English is then something that is negotiated, and it is the language to get the work done (Björkman, 2009).
As ELF brings new paradigm of using English, there comes also a lot of debates of how ELF might create the reduced type of English.In development, Pennycook (2009) later takes the lead in proposing that English needs to be treated flexible because language itself is always negotiated in communication.Besides, as the non-native speakers outnumber the native speakers, the use of English has been much influenced by the need to understand each other and gain agreement rather than taking sides of which English is best to use.Therefore, this also gives a new breath to the teaching of English in which the focus should no longer about how to achieve the native speakers' proficiency but how to provide access to become resourceful speakers.Being the resourceful speakers, the students will eloquently use the language effectively in diverse contexts with different people.
Given the background, ELF may therefore be a solution to preparing the nursing students ready to work on the international community meeting with patients from the diverse cultural identities among the non-native speakers' communication.However, it is yet unknown whether it will be a success or a failure unless the students' perceptions are taken into account (Nickerson, (2003).Students' perceptions are the major determining factors in showing whether or not an approach has communicative benefits (Jenkins, 2018).A number of studies have focused on the teachers' and students' perceptions of ELF.However, as far as the researchers know, there has not been any study done in the context of nursing students in Indonesian context.Therefore, this study was designed to investigate the following research questions: 1. Which English is favoured, and which English is needed by the nursing students?2. What are nursing students' perceptions of English as a Lingua Franca?
LITERATURE REVIEW English as a Lingua Franca Jenkins, Cogo, and Dewey (2011) state that the use of English in a place where there is little interference of the native speakers to achieve the target of the communication is the use of ELF.Through ELF, the meaning making among the speakers is done with the purpose to understand each other.Therefore, the grammatical errors and improper dictions are normally let go since both the speakers are not the native speakers (shared-non-nativeness) (Cogo, 2010).Within the ELF emergence, achieving the goal of the communication and being able to negotiate the meaning are considered as the successful communication.Further, Jenkins, Cogo, and Dewey (2011, p.284) assert that: "ELF perspective sees non-native Englishes as different rather than efficient.Differences from Standard English are not assumed to be signs of incompetence, …but… as emerging or potential features of ELF" (emphasized) There has been a long exhaustive discussion regarding the emergence of ELF among the applied linguists concerning the idea of accepting the grammar inaccuracy and cultural identities within the language.Sowden (2012) suspects that ELF will make a new language system replacing Standard English (SE), lead to misunderstanding and create problem in its use.Besides, Shim (2009) having the same idea states that the non-existence of shared 'lingua-franca core' among the non-native speakers will create the communication problem.
Answering to this query, Jenkins (2018) contends that what should be taught at class is Standard English (SE), emphasizing that ELF emergence does not to replace it.She explicitly states that "the aim of ELF researchers has never been to propose an alternative model of English, let alone a monolithic version that should be taught in all contexts" (Jenkins, 2018, p. 305).Pennycook (2010) says that ELF is not a language variation that needs to be seen as a linguistic system but the local use of English.What can be implied is that ELF emergence is by the result of the negotiation of the communication among the multilinguals not a new system designed.Canagarajah (2007a) reminds that ELF is not a fixed set of system that can be regulated unless when it is used in communication.Therefore, ELF is not a product, but a continuous social activity process which is negotiated through the conversation and switched based on the contexts (Sukanya, 2018).
The idea is in the context of the multilinguals, ELF becomes the language that unites and acts solely as the language for communication.It is no longer becoming English that sticks on the one stiff standard but allowing every possibility emerges from the cross-cultural language use.Therefore, the English that needs to be taught at the class now transforms into English that enables the students to be 'a resourceful speaker' in achieving the communication goal (Pennycook, 2014).
Aligning with Pennycook's (2014) proposal of becoming resourceful speakers, Kirkpatrick (2014) designs an emphasis for the ELF approach principle as follow; that (1) native speakers' proficiency is no longer the linguistic target but achieving the goal of the communication; (2) the native speakers' culture is not what should be taught but the intercultural competence; (3) the local teachers teach English better for their local culture understanding; (4) ELF environment is best for language learning; (5) spoken English is different to written English; and (6) ELF assessment needs to be designed to meet ELF neighbourhood.Therefore, while teaching is based on the SE, the emergence of ELF is welcomed as the product of the spoken English by multilinguals which is influenced by the local use.It is not shifting to the teaching local English but to be aware of the possibility of the local English emergence.In the end, students become aware of the difference between the contexts of talking to the multilinguals and the native speaker thus able to decide which English to use.Sifakis (2017) reminds that teachers' focus is not to teach ELF in the classroom but more into growing the awareness within students; not about whether the materials, textbooks, and teachers are endorsing ELF but the extent they do.This way, there should not be conflict whether ELF is diminishing the use of English as Foreign Language (EFL) but aware to whom the language is being used.It is "the capability and choice to decide the extent to which ELF and EFL can be linked depending on the idiosyncrasies of each specific context" (Sifakis, 2017, p.8).

Previous Studies in ELF
Apparently, the previous studies show the diverse responses around the perceptions toward ELF.At one hand, Ranta (2010) in a study of ELF in Finland and Ehrenreich (2010) in German show that students use English creatively to achieve the target of the communication and do not worry too much about the grammar inaccuracy.Kirkpatrick (2017) support these findings through his study that ELF helps students to be aware of the cultural variation in language use which transform them into interpersonally skilled.Further, Cogo (2010) finds out that students are becoming more attentive whom they are talking to, so they can creatively use communicative strategies in delivering ideas and avoid miscommunication.The students go through meaning-making, confirmation and clarification and other types of communicative strategies which are perfectly documented by Kirkpatrick (2011) in his book 'English as a Lingua Franca in ASEAN'.Therefore, Seidlhofer (2004) says that miscommunication is rare in EFL.
At the other hand, study in Vietnam and Turkey show the contrast.Students are found to acknowledge the existence of ELF but somehow prefer to aim for the native speakers' accent because they feel cool when they are able to use it (Ngo, 2016;Incecay & Akyel, 2014).Sifakis (2014) also finds out that both teachers and students think that native speakers' pronunciation and accents are the success standard of learning English.Overall, the results of the studies are yet contradicted, in which teachers should be more aware and flexible in their teaching so they will no lean toward any sides too much but aim at creating resourceful speakers.

English Language Teaching in Indonesia
Indonesia, in its long history of language teaching has long embraced the native speakers' proficiency as the standard of a successful English language learning (Jayanti & Norahmi, 2018).Students are taught with the norms of the native speakers by using the materials published by the native speakers, playing clips of conversation, role-playing, and testing them to see the closeness to native speakers' proficiency.However, this is proven to no longer effective and unnecessary (Wang and Hill, 2011).The fact that the international communities primarily comprise of rich social and cultural contexts makes that of native speakers' proficiency not enough for Indonesian's students (Cahyono, 2013).
In fact, the favour toward the native speakers' proficiency is no longer effective.Indonesia has been said as one of the countries in ASEAN community which speak the lesser English compared to other fellow countries (Sukyadi and Hermawan, 2019).Furthermore, Indonesia is currently striving to invest in its tourism and exchange programs to generate successful English communication.In this light, a number of Indonesian scholars have started to facilitate the discussion of introducing ELF pedagogy to the classroom (Zacharias, 2019;Sukyadi and Hermawan, 2019), criticize the language in education policy, and propose the English teachers training (Musthafa, Hamied, and Subhan, 2019).Indonesia is in need of a more flexible English to enable its students gaining access into the international communities which no longer a tied to a matter of British English (BrE) or American English (AmE).The first step suggested by Subhan ( 2019) is by making a transition in the teacher training, familiarizing the teacher with ELF and growing the receptive awareness to ELF.Further, being ELF aware (Jayanti & Norahmi, 2018) the teachers will "tolerate their students' imperfection in achieving the standard of native-like correctness and acknowledge the cultural and social background diversity among non-native speakers" (p.12).

METHOD
The main purpose of this research is to delve into an understanding from the social phenomenon.Therefore, the methodology used was qualitative framework.This study took the form of a case study because it helped answering the questions of this study by collecting the data explicitly and implicitly from the participants (Yin, 2006).
The participants of this study were 10 nursing students (five 5 males and 5 females) who were selected based on the 'purposive and homogenous' sampling criteria.It was employed because the purpose of this study was to investigate the information-rich case deeply (Patton, 2015).From the information-rich case, the researchers were given access to study the participants' perceptions which were the centre of the research (Polkinghorne, 2015).Van Manen (2014) suggests that purposive sampling indicates that the participants' selection was based on the basic knowledge and the verbal competence of the participants to explain the problem studied and to answer the research question.Accordingly, 10 participants who got the top ten positions in the diagnostic test at the beginning of the class were selected (Casanave, 2015) considering that they would be able to answer the research questions.Besides, homogenous sampling was also applied because the samples had the same background; fully funded, same semester and career path (Walliman, 2010).
To help exploring the students' perceptions of ELF, the researchers generated their own primary data by employing the open-ended questionnaires (OEQ) (Fraenkel, 2008) It was best employed because it helped delving the complex issue in which simple answer are considered insufficient to answer the phenomenon researched (Cohen, 2007).The OEQ were distributed through google form and set to answer the first research question.
The semi-structured interview tapped to answer the second research question which was also related to the participants' answers from the OEQ, so their perceptions of ELF were explored thoroughly.The aim of choosing semi-structured interview because it scrutinized the participants' perceptions of something intensively over a phenomenon or a situation (Boyce & Neale, 2006).To add the validity and for the transcription's importance, the interview sessions were recorded using the audio-recording.
Since the instruments were designed specifically to explore the nursing students' perceptions of English and ELF, they were first discussed with the researchers' colleagues and then piloted to test the validity.Then, the instruments were distributed through the process of data collection.
Students of top ten achiever were put into a WhatsApp group and asked if they were willing to participate in the study.Those who wished to, were given the link to fill in the schedule that best met their time for data collection.Those who did not, were politely asked to leave the group chat, so the researcher contacted the top fifteen privately and put them into the group.The data collection was started by firstly signing the informed-consent form.Then the OEQ was distributed in Google form link where the students filled their answers for 15 minutes.In-depth interview took place after filling in the OEQ and took about 30 minutes.The students were notified that the interviews were recorded using audio-recording.For the students were more comfortable speaking Bahasa, so both OEQ and semistructured interview were fully done in Bahasa.
The ethical issue was also taken into consideration in designing and conducting this research.The data collection was done after the participants understand the purpose of the study and their involvement in the research; roles, right, and responsibility.The proposal also had passed the ethic test from the local ethic committee.
The data were sort into data OEQ and semi-structured interview.Data interview were transcribed and then member-checked with the participants to confirm the data.Then the data OEQ and interview were analysed using qualitative content analysis (Cohen, 2007).
The researchers read the data as a whole and highlighted the interesting keywords from the data.Richard (2005, p. 69) states that there is no certain measure in how many readings are needed when coding because it is reading with purpose.After rereading the data for several times, the researchers did the initial coding by looking at keywords highlighted until some codes were established.The codes were then grouped into structured categories.After establishing the categories, the researchers revisited the data and did the second coding to check whether the coding had been accurately done.Finally, the researchers began to write up the categories.The excerpts from the interview transcription were also attached to the analysis to add the trustworthiness and the validity of this study.

FINDINGS Preferred and Needed English
The participants were asked to whom they spoke English the most with and all acknowledged to have never talked to the native speakers.
'The majority in my neighbourhood are those who are non-native speakers, so I mostly speak with them.' (B3) Although no participants had ever been in direct contact with the native speaker, almost all the participants favoured BrE as the most sophisticated accent to pick up more than any other types of Englishes.
'It feels like when people are talking in British Accent, it sounds so cool.Their pronunciation is wow, but for me, it is so difficult.'(G1) The same view toward the BrE was also expressed the other participants.The participants assumed that BrE has cool pronunciation and intonation.The reason behind the siding was traced down to find that movie affects one's preference of English.B5 states that he chose BrE for his love for Harry Potter.B5 stated that he was an avid fan of this movie.
'Because I love the Harry Potter movie.In that movie, they speak using the British accent and they inspire me a lot.' (B5) B4 also described that he always watched the 'Britain Got Talent' in YouTube which groomed his preference toward the BrE.
'I really love to listen to listen to music.I am used to listening British accent with its pronunciation and intonation which is lovely to hear and easy to memorise in Youtube.' (B3) However, when asked about the English they needed, they participants blurred their view between English preferred and English needed.The participants in fact, thought that English they needed for the future is English that promotes the understanding between them and the patients.
'Most importantly is the information exchange between both patients and nurses are easily understood so it can create a therapeutic communication.' (B3) Their preferences of intelligible English were somehow intrigued by their insecurity of their English ability.This insecurity was reflected as shown below: 'I am afraid that I will not be able to talk properly with the patient that will result miscommunication.' (G5) As a result, the students opted for the English which did not intimidate them and so they could catch the implied meaning, thus avoid the miscommunication.
'(I need) English, which is easy to understand, pronounced slowly so I can catch the meaning clearly and does not use complicated vocabularies.'(B2) Being realistic about their insecurity and their ability in their skill, the participants decided to choose intelligible English as the English which they needed.
'I choose simple English which is easy to understand.If needed, I will learn more varieties of English such as English which is generally used by native speakers to be able to switch between formal and informal situation.'(G4) Therefore, the results of this study highlighted the participants' contrasted view about English they favoured and English they needed for their communication with the patients.The choice of favoured English was highly influenced by the modern cultures while the English needed was because of their insecurity of making mistakes.The participants were aware that their English was not to impose their authority but to create therapeutic communication.Besides, there was an indication that the students were aware of Englishes which can be switched in different situations.

The Nursing Students' Perceptions of English as a Lingua Franca English connects international community
The interview started with the question of the participants' perception when listening to the word 'English'.Surprisingly, no one mentioned English in terms of ownership, but ten out of ten participants thought that it was the language for the foreigner and used as a tool of communication for those who did not share the same language.
'When listening to someone's speaking English, I am always thinking, Hmm, he is a foreigner.'(B1) 'English is a language that enables us to communicate with each those with those who do not speak our language.'(B3) Looking at these excerpts, the participants were not exactly bothered by the heated debate about the ownership of English and not impacted them by any means.Their concept of English was that English is used by almost all countries in the world to communicate and unite people.
'(English is) … a language used internationally, the language which is used in almost all part of the world, because the only language that UNITES is English.' (B5) Therefore, this finding indicated that the student's perception of English is as a mere tool of communication and has no power imposing within it but connects those who do not share the same language.

Strategies used to achieve the goal of the communication
From the data, the participants were already aware of the varieties of Englishes since they had Filipino lecturers at class and had been connected to the vastness of the information and entertainment access.They were aware that diverse cultural backgrounds may affect one's accents.Therefore, when asked which aspect was most vital to an English conversation, the participants agreed that it was promoting intelligibility.As had been hinted through their answers in the OEQ, the participants thought that the most important thing in a successful communication was achieving the goal of the communication.Therefore, to achieve the goal the participants first assumed that accents and grammar could basically be learned, and they came together with the practice.
'So, if one is talking with inaccurate grammar but we can still understand, I think that is totally fine.Because slowly later, if we want to try (speaking with grammar), we will definitely be able to.' (G5) Besides, the participants, foreseeing their future responsibility reflected that the English that they were going to use was English that was more flexible.Since they were not using English to give instruction strictly but in a friendlier way, so it was always okay to let go the accents and the inaccuracy of the grammar.

'(Speaking) with patient will be more enjoyable. …because we are talking to them as their friends. So, if the grammar is inaccurate, most importantly, we know what he needs and what we are about to do. That's what I think what will likely happen in the hospital.' (B3)
Second, the participants expressed that the target of the communication could be achieved when much simpler vocabularies were used in conversation.

'Hmm, as long as we understand what we mean by each other, it is okay, but say like…like there is one new word which is unfamiliar, probably we can explain using much simpler words.' (B1)
The third strategy was explained by the other participant.He proposed that in communication, one needed to highlight what was important key point, so he could focus on emphasising it.

So, when one is about to say something what he thinks is important … so automatically (he will take into account) what he considers important, who he is and what the talk will be. So, he knows what is important. Like okay I need to give easier sentence to understand. Therefore, those who receive the information understand, so they are both engaged (within the talk). (B5)
Besides, aware that the patients would highly likely to have diverse background, there was an emergent initiative coming from the participants of how to deal with different patients.Fourth, the participants were aware that they needed to be able to shift their English use based on who they talked with.
'So, first, in the hospital system, patients are those who are served.… So, I need to adapt with them.So, whether, he is a Brit, … even if his English is mixed (because he is) Asian, I need to adapt with them.So, I my use of English will depend on my patients, because I am serving them.' (G1) The same thought was also expressed by G5.She firmly believed that her English needed to shift depending on the patients she was talking to.Although she hoped she would be able to use BrE, she somehow understood that the patients' English were going to be diverse.

'I prefer to use BrE. (But when using it), if my patients look at me …
like what?Showing their confusion, probably that is the time when I should shuttle.Suppose they do not look like they understand, and I grasp the sense that where they are from, so yeah that's the time when I must use easier English to understand, easier for them to understand.' (G5) Therefore, this finding suggested that the participants were aware that what mattered in the communication was whether or not the goal of the communication was achieved.Therefore, to achieve it the participants were creatively thinking of the strategies of how they would talk to the patients, and in what context they would engage.

Local teachers teach English better
Exploring the depth of the participants' perceptions of ELF, this study also scrutinised their perception of which teacher met their needs best.In fact, local teachers were picked to teach English better for the following reasons, 'For the comfortability, in my own class, uh I prefer teacher from my own country, an Indonesian.Because, when we, what you call … (…) when we do not understand some sentences, the teacher ah who teaches us … can explain back to us using our mother tongue.' (B3) Besides, participant also thought that local teachers were easier to understand because they used the language as users in which they were once learners too.
'Because they are speaking using the grammar that we both learn, and then they are like trying to pronounce it the way Indonesian speaks it in Bahasa, so yeah, we kind of grasp the meaning that way.' (G4) Although the data drew our attention to the indispensability of the local teachers, one of the participants' statement also gave new light to what kind of local teachers they expected.
'Indonesians (who) have studied abroad or at least travelling abroad so they can share their cross-cultural experiences.' (G2) Therefore, this finding indicated that a local teacher did not solely have the right to teach just because they shared the same social backgrounds and were once learners, but these local teachers needed to have the rich cross-cultural experiences such as travelling or studying abroad.

ELF reflects the idea of Identities
As ELF also sparks the idea cultural variations and that students are expected to be considerate about their speaking partners' cultural background, ELF then can speak for one's affiliation identity category.In this study, the participants were found proud to be identified as Indonesian through their English.

unique characteristic when speaking English. So, I'm glad if they can identify me Indonesian.' (B1)
The participants also expressed that they felt proud when people recognised that they came from Indonesia.It gave indication that people knew about Indonesia.
'I personally feel glad…why?because when we talk with them, and they know us Indonesian meaning that they learn a lot about Indonesia.' (B3) In fact, ASEAN countries shared the same background and ancestor.Therefore, the appearance of the people particularly between Malaysia and Indonesia appeared similar.Therefore, having something specific that could show the difference between both concerned the participant.'I will be proud (using Indonesian accent in speaking English), because… because we have the English that is unique, so having this characteristic even though, our faces look alike between Indo(nesia) -Malaysia, our accents speak that we are Indonesian.' (G2) This finding indicated that ELF opened the room for the participants to be creative about their English use to indicate their cultural background.

Introducing ELF to the classroom.
The data illuminated the idea of introducing the ELF into the classroom.The participants reflected that they wanted to be introduced to the Englishes available, so they would be well prepared when one day they involved to diverse patients at hospital.'…It will make things easier…meaning that if we have been introduced (to ELF) earlier, we won't be that surprised.When listening to him speaking, so we know that he is using this English accent, so yeah, we know we need to use that English.Although we cannot be like him totally, but at least we can modify like adding information to it so, we will not be confused.'(G5) The participants also showed their enthusiasm of having the ELF in the classroom, foreseeing that having ELF at hand would help them to shuttle their Englishes according to whom they were talking.
'I definitely agree, because at class we have got the BrE and AmE, then we are made aware of the Indonesian accent.So, when later talking to an Indonesian we do not need to talk exactly using BrE accent, we can use our own accent, so we can be more accepted in the community.'(G2) However, although the participants agreed that they should be introduced to the use of English as ELF, all participants opposed the idea of teaching ELF as the only English in the classroom.They argued that there should be a 'one right English' for people to look up to.
'…There need to be a, there must be a 'STANDARD'.So, people will have the rules speaking, because yeah at one side (I agree) people can speak using their own cultural accent, yeah, but at class, it is not right to speak using own cultural accent.' (G1) This finding indicated that students were aware instruction to ELF was important, so they would not be surprised when they were in the field but against the idea of teaching it without standard.

DISCUSSION
Research question one aims to find out the participant's view between the English they favour and need.Through the findings, it is found that the participants have the centric view about their favourable English.Eight out of ten participants favour BrE as the ideal type of English.The participants think that BrE sounds cool.This result corresponds with the previous studies of Sukanya (2018), Galloway (2011) and Matsuda (2003b) who have earlier showed that the majority of non-native speaker picks either BrE or AmE as favourable because it sounds cool, although they agree that it is difficult.In fact, the centric view of English is still pervasively lived by the participants.The view that SE is superior and is as the indicator of a successful communication is still what is formulated at the English language class (Cogo, 2011).Besides, modern cultures also take part in influencing the choice of BrE preferred by the participants.The interconnectedness through the internet and social medias expose the participants to the inner circle country's cultures including movies, music, trends, and lifestyle.Their exposures influence their preferences of what are being cool thus try to impersonate them for themselves.This explains the irony of why the students find that BrE is difficult yet finds it cool.
However, the 'cool' side of the BrE impersonated is blurred when the participants are asked about English they will need in their future communication with the patients.The participants' choice of English needed is contrasted with English they desire.They are found to be realistic about their English use in the future that is an 'easy-tounderstand English'.Rather than opting for something cool, they think that delivering the message and creating the therapeutic communication matter the most.The choice of choosing 'the easy-tounderstand English' is traced down.It is found that the participants' insecurity due to the lack of ability influence their English choice.They feel intimidated about making mistakes, so they expect the communication to be simple in terms of vocabulary and most importantly they can deliver and infer the message clearly.After all, they are aware that their English is not to impose their authority but to create the therapeutic communication and gain trust from the patients which are vital in their job as a nurse.Interestingly, as the participants are now aware that they may not be able to use BrE to their patients due to their English skill, they show the understanding that Englishes can be switched according to whom they are speaking with.This resounds what Canagarajah (2015, p. XXV) has called as the ability to "shuttle between communities." The second research question aims to tap on the participants 'perceptions of ELF.The interview was started by familiarising them with the topic and slowly weaving to the core topic.Interestingly, the participants are found to view English as solely the tool of communication.It is the language of the people who do not share the same first language.Therefore, English unites people in a room without imposing which English is better.However, contrasting to how they favour BrE over the other Englishes makes it interesting to point that the influence of the modern cultures may have been the biggest cause to their choice of favourable English.They view English as merely as a tool of communication yet head over heel toward specific English because of their exposures to the cultures through online media.Previous study has indicated that popular cultures motivate the students in improving their communicative and intercultural competence 2016).
Nonetheless, the participants of this study are aware of their lack of ability into gaining the native speakers' proficiency and that there are people from diverse cultural background who use English like they do.Coping with these two realities, the participants creatively formulate the strategies of how to get their message across and get the job done.Through the findings, firstly, the participants think that letting go the accent and the inaccuracy of the grammar is one of the strategies that can be used to achieve the goal of the communication.They believe that the most important thing is to focus on the mutual understanding so they will be able to know what the patients are currently experiencing thus they know what certain treatments are to be taken.This again has resounded what Firth (1996), House (2006), and Kirkpatrick (2010) have already disseminated that the non-native speakers let go all the inaccuracy of the grammar and accent long as the goal of the communication is achieved.Secondly, the participants are aware that they need to use simpler vocabulary, if they want to get their messages across.The use of high frequency words is promoted so they will easily understand each other.By doing this, the participants can ensure the communication going and save each other's face.Thirdly, highlighting the most important key point is what the participants creatively propose in order to reach the goal of the communication.Arguably it is not only about the matter of simpler vocabulary but more into the willingness into explaining the information by describing and putting the emphasis on that specific information.This could be related to what to what Kirkpatrick (2013) called as 'rephrasing the phrase' in which the participants repeat the ideas so other who do not understand may get the gist that the point repeated is important.The participant in this way can also use the insertion the sound to make the message clearer or even pronouncing in the local dialect.This way, the misunderstanding can be avoided, and patients can be taken care of according to their needs.Fourthly, the participants see the importance of being able to switch their English based on who they are talking with.They are aware that the patients they are going to meet are diverse, in which to show them caring and compassionate care is through communication.Therefore, they see the importance of knowing variety of Englishes to enable them to converse with diverse patients by shuttling their Englishes.What the students envision through this data aligns with what Canagarajah (2011) has proposed as 'shuttle situation' ability in students so they could switch their dialects, languages and multimodalities to achieve their purposes and therefore prove that ELF is emergent and adaptive (Seidlhofer, 2004).
The next finding gives light that local teacher teaches English better.The reasons behind include the fact that local teacher shares the same first language with the students, so when there are some vocabularies they do not understand, the teacher can use simpler vocabularies and relate it to the social context or even tell the meaning in their mother tongue.Besides, the local accent use helps the understanding easier since English is delivered in the way they are delivered in local language.Besides, being once a learner, local teacher is more aware of the students' difficulty in language learning.They know what to stress in their pronunciation and what diction to use to best meet the socio-cultural background of the students, so they can make inferences to the topic being discussed.The same pronunciation, background and high frequency words which are usually taught at class make the teaching and learning go smoothly.This urgency has also been earlier emphasised by Kirkpatrick (2011) that adequately trained local teachers impact better than the native speakers of English.Besides Cummins (2005) also sees that the explanation of phenomenon and concept using first language impact better in the students learning.In this study, the participants see the importance of having the local teachers who are enriched with interculturalities as the result of cross-cultural experiences.This gives light to what the future local teachers need to pay attention to.They need to be given suitable trainings to arm themselves with an ongoing personal development and cross-cultural experiences.
As the participants are becoming more aware about the diverse cultures within the interaction, they also see the room for their affiliation identity category.Of how to claim the differences among the similarities shared within the Southeast Asia context, they consider ELF may speak for their affiliation.This claim is well explained by Jenkins (2007, p. 191) of how "L2 English speakers identify with the English language and its users, and their sense of how they see themselves and how they want to see themselves in English."This interestingly sheds new light that the participants to an extent no longer wish to sound like the BrE but to be identified by their own affiliation.After all, having this affiliation identity category may lead to the establishment of one national identity (Kirkpatrick, 2011) which may become solution to Indonesia's prolonged debate about whether or not to apply English as a medium of instruction due to the national identity issue.
Finally, the study also finds out that the participants agree if they are to be introduced to the ELF at the classroom so when they meet people, they can keep the communication going and being very considerate about their patients.Introduced to many types of Englishes will make them aware of different dialects used by the patients thus benefit their own career as nurses (Sukanya, 2018).Besides, the participants see the possibility that they can be speaking English using local accent.There will not be authority over the English but more into comfortably exchanging information.In fact, Indonesians speaking English are not as many as those in other ASEAN countries.This is because people have always put SE as the right version of English to speak.People are afraid to speak English in public because they are afraid of being humiliated for using a localised English accent.Therefore, being introduced to ELF in classroom, the participants are looking forward to bigger opportunities of English interaction.However, the participants oppose the idea of teaching EFL as the sole English into the classroom.There should be a standard according to them, so people will not speak as they want and cause misunderstanding.Therefore, they agree that SE should stay as SE, so people will have the standard to come back.
The participants' point of view reflects that of Kaowittanakul's (2018), Canagarajarah's (2015) and Kirkpatrick's (2013) and Jenkins' (2018) stance of having SE alone taught in the class as the only standard to follow.ELF again is practice-based local language (Pennycook, 2010) which is the product of spoken SE and takes place an informal situation (Sukanya, 2018).

CONCLUSION AND IMPLICATIONS
This study has unveiled the nursing students' contrasted perceptions of English as a Lingua Franca.The findings thus contribute to the preliminary steps of incorporating the pedagogical moves toward English language teaching at classrooms.The implications of the study are summarised as follows:

Aiming for resourceful students
This study reveals the nursing students' perceptions of ELF of how the students are aware of the benefit of understanding English from diverse cultures will benefit their career at the hospital.Responding to this awareness, the teachers may now shift the focus of the language learning from gaining the native speakers' proficiency into becoming a resourceful speaker, "turning our focus on how people manage to communicate in contexts of diversity, that is a form of principled polycentrism" (Pennycook, 2014, p.7).The teachers need to devise the study plan which both introduce SE and ELF without discrediting any of them.SE should be taught as the only form but not supposed to be the aim of learning, but of how to achieve the goal of communication in the context of multilingual.In this respect, the students will be able to add and drop their Englishes based on who and when they are talking.
Aiming for resourceful speakers, the syllabus and the assessment may be needed to be revisited into creating the resourceful speakers.The syllabus may need to cover the introduction of ELF in nursing context and thus the assessment should not aim to assess the native speakers' proficiency but to check whether the students have been able to use the communicative strategies in keeping the communication going, whether they have been able to reach the goal of the communication, whether they have been able to shuttle their Englishes contextually.

Teaching the communicative strategies at classroom
The participants of this study creatively display some of the communicative strategies that they may use in delivering information.Although they have never been taught before about them, they have been able to figure out the importance of achieving the goal of the communication in nursing context.Kirkpatrick (2010) has elaborated communicative strategies that can be used as the steppingstone of teaching the students of how to reach an agreement.Therefore, discussion and role-playing about certain topics in hospitals situation can incite the students' creativity of how to cope with the real conversation with patients in the future.
The easy practice of the learning model can be done through playing the movie clips of the patients in Southeast Asia speaking different accents and performing role play by using certain accents.This will familiarize students with different accents, and they will become more creative in using different communicative strategies.

Training nursing lecturers with cross-cultural experiences
This study also unveils that students prefer to have the local teachers at the classroom, but they must have the cross-cultural knowledge.This sheds light to the policy makers, in this case to the faculty of nursing that they may need to devise a benchmarking for the local teachers.This is intended to give them the cross-cultural experiences, so they experience the ELF use, then synthesize and formulate the suitable material into the nursing classrooms.The benchmarking may be started from the southeast Asia's circle and expand it based on the need.In conclusion, the teachers need to drop their favour of which English is best but able to role-model when to use specific English.